COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
Adolescents with SUD. . .
• Have been adjudicated delinquent
• Are overrepresented in the Juvenile Justice Sysytem
• Are largely undiagnosed or misdiagnosed psychiatrically
• Have histories of child abuse, neglect and sexual abuse;
• Have high co-morbidity with psychiatric conditions;
• Have high co-morbidity of ADHD and Learning Disorders –
Usually Undiagnosed
• Distributed across diverse health & social service systems
Characteristic Behaviors
and Attitudes In Normal Adolescence
• Experimenting
• Practicing
• Questioning and challenging
• Peer bonding
• Here and now focus
• Sense of invulnerability
Challenges to “Normal” Adolescent
Development
Challenges to “Normal” Adolescent
Development
• Genetic Vulnerabilities / Predispositions
‣family history of Substance Use Disorders
‣family history of Psychiatric and other Associated Disorders
‣family history of medical illness
• Learning and Attentional Disorders
• Other Physical Cognitive Disabilities
• Parental / Family / Caretaker Dysfunction
• Medical Illness
• Trauma (Sexual, Emotional, Physical)
• Active Addiction and/or Psychiatric Disturbance
• Community and Environment
• Single Parent Homes
• Poverty
• Wealth
Characteristics of “Normal”, Substance Abusing & Antisocial Adolescents
Domain
“Normal” Adolescent
Substance Abusing Adolescent “Antisocial” Adolescent
Purposes of Assessment
Affect
Moodiness
Drastic Mood Swings –
Angry and Controlling – Or
Guilty Anger
Calm, Cool and Charming
Worldview
“I should be able to do anything I want
to.” “ I feel like I am not as good at
things as I would like to be.” “If I steal I
“I’ve done some bad things and I
feel guilty.” If I don’t stay on top of
things, people will find out I’m
“I’m cool – you don’t matter
unless you have something I
want.” “It’s not bad unless you
• Establish a working relationship
might get caught, then people would
bad.” “I have steal to get money –
get caught.” “You're a fool and
Presenting
know I am a thief!”
Moodiness, Feeling Insecure, Not
besides, all of my friends do.”
School problems, family conflict,
deserve to be ripped off!”
Violent behavior, violent crimes,
• Engage the adolescent
Problem.
Liked, Don’t Fit In
change of friends, drastic mood
swings, lying, legal problems: theft,
B&E, etc.
rageful outbursts, Families &
others injured and the like
wreckage following the trail of
the antisocial.
• Demystify the process
Social
Functioning
Good achievement, positive peer
group, Interests and/or outside
involvement
Current problems and other things
grow progressively worse
Excellent functioning, i.e. Class
President, in charge of
everything, smooth talker- Or-
Poor functioning, numerous legal
• Engage Parents / Guardians
Motivation
Autonomy – Peer Identification
To avoid further problems, return
to previous positive functioning,
regain acceptance & trust of family
and peers
violations, volatile relationships
To “Win”; Be right; Control; Seek
Stimulation & Excitement;
Immediate Gratification, Ends
Justify the Means
• Assess Competencies, Capacities &
Resiliencies
Defenses
Isolation, Minimizing, Externalizing
Lying, Manipulation,
Con, Split off Affect,
Rationalization & Increased Use of
Intellectualizing, Rage
Thinking Errors
&Intimidation
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